METHODS: Qualitative design based on focus group interviews in a primary care context in Region Västra Götaland, Sweden. Strategically selected professionals from different SRP organizations discussed sick leave outcomes and the rehabilitation process. Analysis was performed with Systematic text condensation.
METHODS: General practitioners (n = 6), rehabilitation coordinators and/or healthcare professionals from primary healthcare (n = 13), caseworkers from the Social Insurance Agency, the Employment Agency, and Social Services (n = 12).
RESULTS: The outcome of the SRP was described to depend upon the extent to which the process meets patients\' bio-psycho-social needs. Aspects considered crucial were: 1) early bio-psycho-social assessments, including medical specialist consultations when needed, 2) long-term realistic planning of sick leave and rehabilitation alongside medical treatment, 3) access to a wide range of early rehabilitative and supportive interventions, including situation-based, non-medical practical problem solving, and 4) trusting relationships over time for all involved professions and roles to maximize process quality and person-centeredness. A gap between the desired scope of the SRP and existing guidelines was identified.
CONCLUSIONS: Interviewees perceived that successful outcomes from the sick leave and rehabilitation process in a primary care context depend on consensus, person-centeredness, and relationship continuity for all involved professions. An extended process scope and relationship continuity for all involved professionals were suggested to improve process outcomes.
方法:在VästraGötaland地区的初级保健背景下,基于焦点小组访谈的定性设计,瑞典。来自不同SRP组织的战略性选择的专业人员讨论了病假结果和康复过程。用系统文本浓缩进行分析。
方法:全科医生(n=6),康复协调员和/或初级卫生保健专业人员(n=13),社会保险机构的个案工作者,职业介绍所,和社会服务(n=12)。
结果:SRP的结果被描述为取决于该过程满足患者的生物-心理-社会需求的程度。被认为至关重要的方面是:1)早期生物-心理-社会评估,包括需要时的医学专家咨询,2)病假和康复与医疗的长期现实规划,3)获得广泛的早期康复和支持性干预措施,包括基于情况的,解决非医学实际问题,和4)随着时间的推移,信任所有涉及的职业和角色的关系,以最大限度地提高流程质量和以人为本。确定了SRP的预期范围与现有准则之间的差距。
结论:受访者认为,初级保健背景下病假和康复过程的成功结果取决于共识,以人为本,以及所有相关职业的关系连续性。建议为所有相关专业人员提供扩展的过程范围和关系连续性,以改善过程结果。